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If Sean Levert had been jailed in March in either of Ohio's two other major urban-county jails instead of Cuyahoga County's, he might still be alive.
Officials at the Franklin and Hamilton county jails both said their facilities have policies that would not have denied R&B singer Levert his doctor-prescribed anxiety medication, as jail staff at the Cuyahoga County Jail did during Levert's last six days of life.
A county coroner's report concluded that Levert's withdrawal symptoms from the drug Xanax contributed to the complications that stopped his heart on March 30. Levert was waiting for a doctor's evaluation to decide if he should be allowed the medicine. The visit was scheduled for April 8.
"If he had been in our jail and Xanax was on the formulary -- if it was a standard-issue drug -- he would have seen a doctor who would prescribe it," said Mark Barrett, chief deputy for jail administration in the Franklin County Sheriff's Office.
Hamilton County sheriff's spokesman Steve Barnett said the same holds true in that Cincinnati-area jail. Both said evaluations are made at book-in.
"If their doctor prescribes it and confirms it to our people, that's what they get," Barnett said.
Cuyahoga County Sheriff Gerald McFaul did not return phone calls on Tuesday and Wednesday to comment on the jail's medication policies.
Several people contacted The Plain Dealer on Wednesday saying Levert's treatment in the jail was not unusual.
One woman called in a panic after reading Levert's story. She said her brother had gone 10 days without getting the Xanax he takes. The brother called family members that morning and told them he was sweating and hallucinating, she said.
The Plain Dealer contacted a jail warden and was assured the man would get medical attention. Later in the day, the sister confirmed the man was given his medicine.
Two women said they weren't given their medications while in the jail. A 33-year-old Bedford woman with epilepsy said she had a grand mal seizure after four days without phenobarbital. After the seizure, she received it.
A 45-year-old woman taking Clonazepam to prevent panic attacks didn't receive her medication for nearly two weeks. She was sweating, crying and had diarrhea and multiple panic attacks before a nurse gave her the drug. And it wasn't until the third week that she met with the jail's psychiatrist, who agreed she needed to continue the drug.
The story of Levert's last hours, in which he was hallucinating and delusional and eventually strapped to a chair, has drawn critical comments from individuals including Cuyahoga County Commissioner Peter Lawson Jones.
Jones said he wants to talk to sheriff personnel to learn the rationale behind the medication policy. He suggested jailers should contact doctors of inmates when they are first brought in to verify prescriptions.
David Fathi, director of Human Rights Watch's U.S. program, said prisons and jails have become the asylum of last resort.
"The number of mentally ill people who end up in prisons and jails is staggering, so these facilities need to be prepared. A jail needs to presume, until it can establish otherwise, that a person coming off the streets has mental health issues. To take away medications and say you won't get evaluated for two weeks is absolutely unconscionable."
But Ed Harrison, president of the National Commission on Correctional Health Care, said Cuyahoga officials were not automatically wrong to withhold medicine from Levert. He said medical officials are legally and ethically obligated to evaluate whether each inmate's prescription is necessary.
Dr. Philip Resnick, a nationally renowned court psychiatrist from the area, said Xanax is an anti-anxiety medication, and most jails will not prescribe it except under unusual circumstances, because it is highly addictive and abuse potential is high.
Harrison's organization grants accreditation to jails that meet accepted standards. The Cuyahoga jail has the accreditation. The standards require at least a cursory medical screening for each inmate upon arrival. Then, Ohio law and the commission standards require a detailed physical evaluation of inmates within two weeks of admission.
In cases of serious medical conditions such as psychosis, "Those people would need to be assessed within two days" under commission standards, he said.
Harrison would not speak to Levert's case specifically.
Levert was a singing star in a family full of them. He is the son of famous O'Jays singer Eddie Levert and brother and bandmate, in the group LeVert, of the late and legendary crooner Gerald Levert.
A judge jailed Sean Levert on March 24 for failing to pay nearly $91,000 in support for three children he fathered before he got married 13 years ago. He gave up a bottle of Xanax tablets when deputies booked him into jail.
Christine Dubber, the jail's health-care services manager, has told investigators that staffers took the Xanax because they didn't consider Levert's anxiety to be psychotic or suicidal.
County Coroner Frank Miller ruled that Levert, 39, died of natural causes -- mainly from complications of sarcoidosis, an inflammatory disease that causes small lumps in the body's organs. Levert's Xanax withdrawal, high blood pressure and diabetes probably contributed, Miller noted in his report.
Cuyahoga County Prosecutor Bill Mason reviewed that report and the sheriff's in-house investigation, then cleared jailers of wrongdoing.
Levert's widow, Angela Lowe, has sued the county for wrongful death. Mason's office is defending the county in the suit. He could not be reached to comment on Wednesday.
Terry Gilbert, a local lawyer with extensive experience in civil rights cases, called the Levert case "particularly egregious because he was crying out for help from the day he got to jail."
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